Examination of alexithymia, psychological resilience and psychiatric symptoms in patients with persistent complex bereavement disorder

Year 2022, Volume: 1 Issue: 3, 160 - 169, 23.12.2022

Burcu Sırlıer Emir , Sevler Yıldız , Aslı Kazğan Kılıçaslan , Kerim Uğur , Osman Kurt

Abstract

Background: The aim of this study is to examine alexithymia, psychological resilience, and sychiatric symptoms in patients with persistent complex bereavement disorder.

Materials and Methods: A total of 62 participants were included in the study, 31 subjects diagnosed with PCBD and 31 healthy controls. Participants were administered the socio-demographic data form, Beck Anxiety Inventory (BAI), Beck Depression Inventory (BDI), Resilience Scale for Adults (RSA), Toronto Alexithymia Scale (TAS-20).

Results: BAI (p<0.001), BDI (p<0.001), and TAS-20 (p<0.001) scale scores were found to be significantly higher in the patient group than in the control group. All sub-dimensions of the RSA scale total score were found to be significantly lower between both groups (p <0.001). The anxiety, depression, and lexithymia levels of the patients diagnosed with persistent complex bereavement disorder were significantly higher than the control group; psychological resilience levels were found to be significantly lower.

Conclusions: We believe that identifying this situation will shape the psychosocial support to be given to individuals in the pathological mourning process

Keywords

Persistent complex bereavement, Alexithymia, Psychological resilience

Kalıcı komplike yas bozukluğu tanılı hastalarda aleksitimi, psikolojik dayanıklılık ve psikiyatrik belirtilerin incelenmesi

Abstract

Amaç: Bu çalışmanın amacı, kalıcı komplike yas bozukluğu tanılı hastalarda aleksitimi, psikolojik dayanıklılık ve psikiyatrik belirtileri incelemektir.

Materyal ve Metot: Çalışmaya 31 KYB tanılı hasta ve 31 sağlıklı kontrol toplam 62 katılımcı dahil edildi. Tüm katılımcılara sosyodemografik veri formu, Beck Anksiyete Ölçeği (BAÖ), Beck Depresyon Ölçeği (BDÖ), yetişkinler için Psikolojik Dayanıklılık Ölçeği (YPDÖ), Toronto Aleksitimi Ölçeği (TAÖ-20) uygulandı.

Bulgular: Hasta grupta BAÖ (p<0,001), BDÖ (p<0,001) ve TAÖ-20 (p<0,001) ölçek puanı kontrol grubundan anlamlı şekilde yüksek saptandı. Yine her iki grup arasında YPDÖ ölçek toplam puan tüm alt boyutları anlamlı şekilde düşük olarak bulundu (p <0,001). Kalıcı komplike yas reaksiyonu tanılı hastaların anksiyete, depresyon ve aleksitimi düzeyleri kontrol grubunda anlamlı şekilde yüksek; psikolojik dayanıklılık düzeyleri ise anlamlı şekilde düşük bulunmuştur.

Sonuç: Bu durumu tespit etmenin patolojik yas sürecindeki bireylere verilecek psikososyal desteği şekillendireceğine inanıyoruz.

Keywords

Kalıcı komplike yas, Aleksitimi, Psikolojik dayanıklılık

References

• Allen, J.Y., Haley, W.E., Small, B.J., Schonwetter, R.S. & McMillan, S.C. (2013). Bereavement among hospice caregivers of cancer patients one year following loss: Predictors of grief, complicated grief, and symptoms of depression. J. Palliat. Med., 16,745–751. doi:10.1089/jpm.2012.0450
• American Psychiatric Association Diagnostic and Statistical Manual of Mental Disorders(5th edition (DSM-5)). (2013). American Psychiatric Association, Arlington.
• Bagby, M.R., Taylor, G.J. & Parker, J.D.A. (1994) The twenty-item Toronto Alexithymia Scale-II: Convergent, discriminant, and concurrent validity. J Psychosom Res., 38, 33-40.
• Basım, H. & Çetin, F. (2011). Yetişkinler için psikolojik dayanıklılık ölçeği’nin güvenilirlik ve geçerlilik çalışması. Türk Psikiyatri Dergisi, 22(2), 104-114.
• Beck, A.T. (1961). An inventory for measuring depression. Arch Gen Psychiatry, 4,561-571.
• Beck, A.T., Epstein, N., Brown, G. & Steer, R.A. (1988) An inventory for measuring clinical anxiety: Psychometric properties. J Consult Clin Psychol., 56, 893-897.
• Bruce, M.L, Kim, K., Leaf, P.J. & Jacobs, S. (1990). Depressive episodes and dysphoria resulting from conjugal bereavement in a prospective community sample. Am J Psychiatry, 147, 608–611.
• Bonanno, G.A. (2004) Loss, trauma, and human resilience: Have we underestimated the human capacity to thrive after extremely aversive events? American Psychologist, 59, 20–28.
• Bonanno, G.A. & Mancini, A.D. (2008). The human capacity to thrive in the face of potential trauma. Pediatrics., 21(2), 369-375.
• Buckley, T., Sunari, D., Marshall, A., Bartrop, R., McKinley, S. & Tofler, G. (2012). Physiological correlates of bereavement and the impact of bereavement interventions. Dialogues Clin Neurosci., 14,129-139.
• Djelantik, A.M.J., Smid, G.E., Kleber, R.J. & Boelen, P.A. (2017). Symptoms of prolonged grief, post-traumatic stress, and depression after loss in a Dutch community sample: A latent class analysis. Psychiatry research, 247, 276-281.
• Eersel, J.H., Taris, T.W. & Boelen, P.A. (2020). Reciprocal relations between symptoms of complicated grief, depression, and anxiety following job loss: A cross‐lagged analysis. Clinical Psychologist, 24(3), 276-284.
• Fietz J, Valencia, N. & Silani, G. (2018). Alexithymia and autistic traits as possible predictors for traits related to depression, anxiety, and stress: a multivariate statistical approach. J. Eval. Clin. Pract., 24, 901–908. doi: 10.1111/jep.12961
• Fletcher, D. & Sarkar, M. (2013). Psychological resilience a review and critique of definitions, concepts, and theory. European Psychologist, 18(1),12–23. doi: 10.1027/1016-9040/a000124.
• Glickman, K., Shear, M.K. & Wall, M. (2016). Exploring outcomes related to anxiety and depression in completers of a randomized controlled trial of complicated grief treatment. Clinical Psychology & Psychotherapy, 23(2), 118-124.
• Güleç, H., Köse, S. & Yazıcı, Güleç, M. (2009) Yirmi soruluk Toronto Aleksimi Ölçeğinin Türkçe uyarlamasının geçerlik ve güvenirliğinin incelenmesi. Klinik Psikofarmakoloji Bülteni, 19(3):213-219.
• Harvard Mental Health Letter (HMHL) (2011). Coping with complicated grief. Harvard Mental Health Publications, 6.
• Harwood, D., Hawton, K., Hope, T. & Jacoby, R. (2002) The grief experiences and needs of bereaved relatives and friends of older people dying through suicide: A descriptive and case-control study. J Affect Disord., 72,185-194.
• Hisli, N. (1989). Beck depresyon envanterinin üniversite öğrencileri için geçerliliği, güvenirliği. Psikoloji Dergisi, 7,3-13.
• KaFeldmanhall, O., Dalgleish, T. & Mobbs D. (2013). Alexithymia decreases altruism in real social decisions. Cortex, 49,899-904.
• Kaya, E. & Aydemir, Ö. (2021). Correlation of alexithymia with grief and depression symptom severity in persistent complex bereavement disorder. Journal of Rational-Emotive & Cognitive-Behavior Therapy, 39(4), 602-619.
• Kayacı, Ü. & Özbay, Y. (2016). Üniversite öğrencilerinin travmatik yaşantı, psikolojik doğum sıraları ve sosyal ilgilerinin psikolojik dayanıklılıklarını yordaması. The Journal of Happiness and WellBeing, 4(1),128-142.
• Kırcalı, E. (2020). Yas sürecinin yordayıcıları: Geçmiş deneyimler, duygu düzenleme becerileri, psikolojik dayanıklılık, sosyal destek ve başa çıkma becerileri. Yüksek Lisans Tezi. Başkent Üniversitesi Sosyal Bilimler Enstitüsü, Ankara.
• Kristensen, P., Weisaeth, L. & Heir, T. (2012). Bereavement and mental health after sudden and violent losses: A Review. Psychiatry, 75 (1), 76-97.
• Lobb, E.A., Kristjanson, L., Samar, M., Leanne, M., Georgia, K.B. & Halkett, A.D. (2010). Predictors of complicated grief: A systematic review of empirical studies. Death Studies, 34, 673-698.
• Lundorff, M., Holmgren, H. & Zachariae, R. (2017) Prevalence of prolonged grief disorder in adult bereavement: A systematic review and meta-analysis. J Affect Disord., 212,138–149.
• Lyvers, M., Holloway, N., Needham, K., & Thorberg, F.A. (2020). Resilience, alexithymia, and university stress in relation to anxiety and problematic alcohol use among female university students. Australian Journal of Psychology, 72(1), 59-67.
• Malkinson, R. (2009). Bilişsel Yas Terapisi. Bir yakınını kaybettikten sonra yaşamın anlamını yeniden yapılandırma. (Çeviri: Akbaş SN). Boylam Psikiyatri Enstitüsü, Ankara: HYB Basım Yayın.
• Marques, L., Bui, E., LeBlanc, N., Porter, E., Robinaugh, D., Dryman, M. T., ... & Simon, N. (2013). Complicated grief symptoms in anxiety disorders: prevalence and associated impairment. Depression and Anxiety, 30(12), 1211-1216.
• Mason, T.M., Tofthagen, C.S. & Buck, H.G. (2020). Complicated grief: risk factors, protective factors, and interventions. Journal of Social Work in End-of-Life & Palliative Care, 16(2), 151-174.
• Nakao, M., Kashiwagi, M. & Yano, E. (2005). Alexithymia and grief reactions in bereaved Japanese women. Death Studies, 29(5), 423-433.
• Newson, R.S., Boelen, P.A. & Hek, K. (2011). The prevalance and characteristics of complicated grief in older adults. Journal of Affective Disorders, 132, 1-2, 231-238.
• Ogrodniczuk, J.S., Piper, W.E. & Joyce, A.S. (2005). The negative effect of alexithymia on the outcome of group therapy for complicated grief: what role might the therapist play? Comprehensive Psychiatry, 46(3), 206-213.
• Parker, G., Paterson, A. & Hadzi-Pavlovic D. (2015). Emotional response patterns of depression, grief, sadness and stress to differing life events: Aquantitative analysis. Journal of Affective Disorders, 175, 229 - 232.
• Robinaugh, D.J. (2015). Examining cognitive ımpairments in bereaved adults with and without complicated grief. doctoral dissertation. Harvard University, Graduate School of Arts & Sciences, Boston.
• Robinaugh, D.J., McNally, R.J., LeBlanc, N.J., Pentel, K.Z., Schwarz, N.R., Shah, R.M., ... & Simon, N.M. (2014). Anxiety sensitivity in bereaved adults with and without complicated grief. The Journal of Nervous and Mental Disease, 202(8), 620.
• Saariaho, A.S, Saariaho, T.H, Mattila, A.K, Karukivi, M. & Joukamaa, M.I. (2015) Alexithymia and early maladaptive schemas in chronic pain patients. Scandinavian Journal of Psychology, 56(4), 428-437.
• Schaal, S., Dusingizemungu, J.P. & Jacob, N. (2012) Associations between prolonged grief disorder, depression, posttraumatic stress disorder, and anxiety in Rwandan genocide survivors. Death Stud., 36(2), 97-117.
• Shear, M.K., Simon, N., Wall, M., Zisook, S., Neimeyer, R., Duan, N., Reynolds, C., Lebowitz, B., Sung, S. & Ghesquiere A. (2011). Complicated grief and related bereavement issues for DSM-5. Depress Anxiety., 28(2),103–17.
• Simon, N.M., Shear, K.M., Thompson, E.H., Zalta, A.K., Perlman, C., Reynolds, C.F., ... & Silowash, R. (2007). The prevalence and correlates of psychiatric comorbidity in individuals with complicated grief. Comprehensive Psychiatry, 48(5), 395-399.
• Skalski, S., Konaszewski, K., Dobrakowski, P., Surzykiewicz, J. & Lee, S.A. (2022). Pandemic grief in Poland: Adaptation of a measure and its relationship with social support and resilience. Current Psychology, 41(10), 7393-7401.
• Soysal, M.N. (2016). Facebook Bağımlılığı ve Psikolojik Dayanıklılık. (Yayınlanmamış Yüksek Lisans Tezi). İstanbul Gelişim Üniversitesi Sosyal Bilimler Enstitüsü, İstanbul.
• Tomarken, A., Holland, J., Schachter, S., Vanderwerker, L., Zuckerman, E., Nelson, C., Coups, E., Ramirez, P.M. & Prigerson, H. (2008). Factors of complicated grief pre-death in caregivers of cancer patients. Psychooncology, 17(2),105-11.
• Ulusoy, M., Şahin, N. & Erkman, H. (1998). Turkish version of the beck anxiety ınventory: psychometric properties. J Cognitive Psychotherapy: Int Quaterly, 12,28-35.
• Verrocchio, M. C., Carrozzino, D., Marchetti, D., Andreasson, K., Fulcheri, M. & Bech, P. (2016). Mental pain and suicide: a systematic review of the literature. Front Psychiatry, 20(7),108.
• Yalçın, S. (2013). İlköğretim okulu öğretmenlerinin mesleki tükenmişlik düzeyleri ile stres, psikolojik dayanıklılık ve akademik iyimserlik arasındaki ilişki. (Yayınlanmamış Yüksek Lisans Tezi). Gazi Üniversitesi Eğitim Bilimleri Enstitüsü, Ankara.
• Yıldırım, A., Hacıhasanoğlu, Aşılar, R., Camcıoğlu, T.H. & Sevinç E. (2016). Alexithymia in Depressive, anxiety, somatoform, and psychotic disorders: a comparative study. J Psychiatric Nurs., 7,75–81.
• Zandvoort, A. (2012). Living and laughing in the shadow of death: complicated grief, trauma and resilience. British Journal of Psychotherapy Integration,9(2), 33-44.
• Zara A. (2011). Yaşadıkça: Psikolojik Sorunlar ve Başa Çıkma Yolları. A. Zara (Ed.). Krizler ve Travmalar (s. 91-121). Ankara: İmge Yayınları.
• Zisook, S. & Shuchter, S. (1993) Uncomplicated bereavement. J Clin Psychiatry, 54, 365- 372.
• Zisook, S., Corruble, E., Duan, N., Iglewicz, A., Karam, E.G., Lanuoette, N., ... & Shear, K.M. (2012). The bereavement exclusion and DSM-5. Depression and Anxiety, 29, 425-443.